Body composition analysis by bioelectrical impedance and its relationship with nutritional status in older adults-a cross sectional descriptive study Body composition in older adults

Main Article Content

Adel Alhamdan
May Al-Muammar
Saad Bindawas
Sulaiman Alshammari
Maysoon Al-Amoud
Philip Calder


Older adult; body composition; nutritional status; primary health care centers; Saudi Arabia.


Objective: Measuring body composition gives an indication of the health status of older adults. To the best of our knowledge, there is no detailed investigation performed to assess body composition and its relationship with nutritional status in older adults, particularly in community-dwelling older adults. Thus, the aim of the study is to assess body composition and its relationship with nutritional status in older adults. Methods: A cross-sectional descriptive study with a multistage stratified sampling design was carried out in community-dwelling older adults in Riyadh city, the capital of the Kingdom of Saudi Arabia. Bioelectrical impedance analysis was used to analyze body composition. Furthermore, the association between body composition and nutrition status [assessed using the mini-nutritional assessment (MNA®) tool], was determined. Results: There were significant differences between older men and women with respect to body composition. Percentage body fat (PBF), fat mass, and fat mass index (FMI) were strongly positively correlated with body mass index (BMI). Those who were classified as malnourished had significantly lower BMI, PBF, fat mass, FMI, fat-free mass, and muscle mass compared to those classified as at risk of malnutrition or well-nourished. Multiple logistic regression highlighted the positive impact of various body composition measures on nutritional status. Calf circumference ˃31cm, significantly decreased the odds ratio (OR) of being malnourished (OR 0.055, C.I. 0.037-0.082). Conclusions: There are differences in body composition between older men and older women, and there is an association between body composition and nutritional status in older adults.


Download data is not yet available.
Abstract 764 | PDF Downloads 369


1. United Nations. Department of Economics and Social Affairs. Population division, ed. World Population Ageing 2017. New York: United nations; 2017 Available from:
2. Jacelon CS. Maintaining the balance: older adults with chronic health problems manage life in the community. Rehabil Nurs 2010; 35(1):16-22, 40.
3. Kshetri DB, Smith WC. Self-reported health problems, health care utilisation and unmet health care needs of elderly men and women in an urban municipality and a rural area of Bhaktapur District of Nepal. Aging Male 2011; 14(2):127-31.
4. Elkhalifa AM, Kinsara AJ, Almadani DA. Prevalence of hypertension in a population of healthy individuals. Med Princ Pract 2011; 20(2):152-5.
5. Almajwal AM, Al-Baghli NA, Batterham MJ, Williams PG, Al-Turki KA, Al-Ghamdi AJ. Performance of body mass index in predicting diabetes and hypertension in the Eastern Province of Saudi Arabia. Ann Saudi Med 2009; 29(6):437-45.
6. Salman RA, Al-Rubeaan KA. Incidence and risk factors of hypertension among Saudi type 2 diabetes adult patients: an 11-year prospective randomized study. J Diabetes Complications 2009; 23(2):95-101.
7. Warsy AS, el-Hazmi MA. Diabetes mellitus, hypertension and obesity-common multifactorial disorders in Saudis. East Mediterr Health J 1999; 5(6):1236-42.
8. Al-Shoshan AA. The affluent diet and its consequences: Saudi Arabia-a case in point. World Rev Nutr Diet 1992; 69:113-65.
9. Jackson AS, Janssen I, Sui XM, Church TS, Blair SN. Longitudinal changes in body composition associated with healthy ageing: men, aged 20-96 years. British Journal of Nutrition 2012; 107(7):1085-91.
10. Frisard MI, Broussard A, Davies SS, Roberts LJ, Rood J, de Jonge L, et al. Aging, resting metabolic rate, and oxidative damage: results from the Louisiana Healthy Aging Study. J Gerontol A Biol Sci Med Sci 2007; 62(7):752-9.
11. Al-Nozha MM, Al-Mazrou YY, Al-Maatouq MA, Arafah MR, Khalil MZ, Khan NB, et al. Obesity in Saudi Arabia. Saudi Med J 2005; 26(5):824-9.
12. Memish ZA, El Bcheraoui C, Tuffaha M, Robinson M, Daoud F, Jaber S, et al. Obesity and associated factors-Kingdom of Saudi Arabia, 2013. Prev Chronic Dis 2014;11:E174.
13. Alqarni SSM. A Review of Prevalence of Obesity in Saudi Arabia. Obesity & Eating Disorders 2016; 2(2:25):1-6.
14. Chumlea WC, Guo SS, Kuczmarski RJ, Flegal KM, Johnson CL, Heymsfield SB, et al. Body composition estimates from NHANES III bioelectrical impedance data. Int J Obes Relat Metab Disord 2002; 26(12):1596-609.
15. Sartorio A, Malavolti M, Agosti F, Marinone PG, Caiti O, Battistini N, et al. Body water distribution in severe obesity and its assessment from eight-polar bioelectrical impedance analysis. Eur J Clin Nutr 2005; 59(2):155-60.
16. Torimoto K, Hirayama A, Samma S, Yoshida K, Fujimoto K, Hirao Y. The relationship between nocturnal polyuria and the distribution of body fluid: assessment by bioelectric impedance analysis. J Urol 2009; 181(1):219-24; discussion 24.
17. Schutz Y, Kyle UU, Pichard C. Fat-free mass index and fat mass index percentiles in Caucasians aged 18-98 y. Int J Obes Relat Metab Disord 2002; 26(7):953-60.
18. Vellas B, Guigoz Y, Garry PJ, Nourhashemi F, Bennahum D, Lauque S, et al. The Mini Nutritional Assessment (MNA) and its use in grading the nutritional state of elderly patients. Nutrition 1999; 15(2):116-22.
19. Alhamdan AA, Bindawas SM, Alshammari SA, Al-Amoud MM, Al-Orf SM, Al-Muammar MN, et al. Prevalence of malnutrition and its association with activities of daily living in older adults attending primary health care centers: a multistage cross-sectional study. Progress in Nutrition 2019; 21(4).
20. Woodrow G. Body composition analysis techniques in the aged adult: indications and limitations. Curr Opin Clin Nutr Metab Care 2009; 12(1):8-14.
21. Fantin F, Di Francesco V, Fontana G, Zivelonghi A, Bissoli L, Zoico E, et al. Longitudinal body composition changes in old men and women: interrelationships with worsening disability. J Gerontol A Biol Sci Med Sci 2007; 62(12):1375-81.
22. Zeinali F, Habibi N, Samadi M, Azam K, Djafarian K. Relation between Lifestyle and Socio-Demographic Factors and Body Composition among the Elderly. Glob J Health Sci 2016; 8(8):53715.
23. Iqbal M, Al-Regaiey KA, Ahmad S, Al Dokhi L, Al Naami M, Habib SS. Body composition analysis to determine gender specific physical fitness equations in a cohort of Saudi population. Pak J Med Sci 2014; 30(4):798-803.
24. Makizako H, Shimada H, Doi T, Tsutsumimoto K, Lee S, Lee SC, et al. Age-dependent changes in physical performance and body composition in community-dwelling Japanese older adults. J Cachexia Sarcopenia Muscle 2017; 8(4):607-14.
25. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al. Sarcopenia: European consensus on definition and diagnosis. Age and Ageing 2010; 39(4):412-23.
26. Kilic MK, Kizilarslanoglu MC, Arik G, Bolayir B, Kara O, Dogan Varan H, et al. Association of Bioelectrical Impedance Analysis-Derived Phase Angle and Sarcopenia in Older Adults. Nutr Clin Pract 2017; 32(1):103-9.
27. Shimoda T, Suzuki T, Takahashi N, Tsutsumi K, Samukawa M, Yoshimachi S, et al. Nutritional Status and Body Composition of Independently Living Older Adults in a Snowy Region of Japan. Gerontol Geriatr Med 2017; 3:2333721417706854.
28. Gallagher D, Heymsfield SB, Heo M, Jebb SA, Murgatroyd PR, Sakamoto Y. Healthy percentage body fat ranges: an approach for developing guidelines based on body mass index. Am J Clin Nutr 2000; 72(3):694-701.
29. Habib SS. Body mass index and body fat percentage in assessment of obesity prevalence in saudi adults. Biomed Environ Sci 2013; 26(2):94-9.
30. Azzeh FS, Bukhari HM, Header EA, Ghabashi MA, Al-Mashi SS, Noorwali NM. Trends in overweight or obesity and other anthropometric indices in adults aged 18-60 years in western Saudi Arabia. Ann Saudi Med 2017; 37(2):106-13.
31. Falsarella GR, Gasparotto LP, Barcelos CC, Coimbra IB, Moretto MC, Pascoa MA, et al. Body composition as a frailty marker for the elderly community. Clin Interv Aging 2015; 10:1661-6.
32. Hengeveld LM, Wijnhoven HAH, Olthof MR, Brouwer IA, Simonsick EM, Kritchevsky SB, et al. Prospective Associations of Diet Quality With Incident Frailty in Older Adults: The Health, Aging, and Body Composition Study. J Am Geriatr Soc 2019; 67(9):1835-42.
33. Chatindiara I, Williams V, Sycamore E, Richter M, Allen J, Wham C. Associations between nutrition risk status, body composition and physical performance among community-dwelling older adults. Aust N Z J Public Health 2019; 43(1):56-62.
34. Schrader E, Baumgartel C, Gueldenzoph H, Stehle P, Uter W, Sieber CC, et al. Nutritional status according to Mini Nutritional Assessment is related to functional status in geriatric patients--independent of health status. J Nutr Health Aging 2014; 18(3):257-63.
35. Winter JE, MacInnis RJ, Wattanapenpaiboon N, Nowson CA. BMI and all-cause mortality in older adults: a meta-analysis. Am J Clin Nutr 2014; 99(4):875-90.